Background/Aim: The relationship between body mass index (BMI) and intradialytic hypotension (IDH) has been inconsistently reported, but no further research has investigated the correlation between body composition and IDH so far. This study aimed to determine whether the lean tissue index (LTI), fat tissue index (FTI), or both derived from body composition monitoring (BCM) is associated with IDH defined as a nadir intradialytic systolic blood pressure of < 90 mm Hg and ≥3 episodes hypotension per 10 hemodialysis (HD) treatments in patients undergoing prevalent HD. Methods: The observational cohort study comprised 1,463 patients receiving thrice-weekly HD from 13 dialysis centers. LTI and FTI were assessed using a BCM machine, a multifrequency bioimpedance spectroscopy device. Unadjusted and multivariable adjusted logistic regression models were fit to estimate the association of body composition with the odds of developing IDH. Results: One hundred and seven patients (7.3%) were diagnosed as IDH. The difference in dialysis vintage, BMI, FTI, LTI, high-density lipoprotein cholesterol, and C-reactive protein between IDH and non-IDH groups was statistically significant (all p < 0.05). The preva-lence of diabetes among IDH patients was slightly higher than among non-IDH patients. In logistic regression models, low LTI and high FTI, but not high BMI were associated with greater odds of IDH ("high" as above median and "low" as below median). When patients were further stratified into 4 distinct body composition groups based on both the LTI and FTI, only the low LTI/high FTI group was connected with a significantly higher odds of IDH (OR 2.686, 95% CI 1.072-6.734; reference: low LTI/low FTI group). Conclusions: The LTI and FTI can provide better correlation of IDH occurrence than the BMI alone in prevalent HD patients. The low LTI/ high FTI appears to be most associated with IDH. An optimal body composition for preventing the occurrence of IDH needs to be determined.
Background Peritoneal dialysis (PD) patients have a high incidence of poor clinical outcomes, which is related to the inflammatory and nutritional status of this population. Platelet-to-albumin ratio (PAR), recently identified as a useful biomarker to monitor inflammation and nutrition, can predict a poor prognosis in various diseases. The aim of this study was to investigate the association between PAR and technique failure and mortality in PD patients. Methods This single-center retrospective study enrolled 405 PD patients from 1 January 2011 to 31 December 2019 and collected complete demographic characteristics, clinical laboratory baseline data. The outcomes were technique failure and mortality. The associations between PAR and technique failure, death were analyzed by Cox proportional hazard models and competing risk regression models with kidney transplantation as a competing event. The areas under the curve (AUC) of receiver-operating characteristic analysis were used to determine the predictive values of PAR for technique failure and mortality. Results During a median follow-up period of 24.0 (range, 4.0–91.0) months, 139 (34.3%) PD patients experienced technique failure, 61 (15.1%) PD patients died. The patients with higher PAR levels had increased risk of technique failure and mortality. After adjustment for confounding factors, we found that high PAR levels were risk factor for both technique failure (subdistribution hazard ratio [ SHR ] 1.775; 95%CI , 1.157–2.720; p = 0.033] and mortality [ SHR 3.710; 95%CI , 1.870–7.360; p < 0.001]. The predictive ability of PAR was superior to platelet and albumin based on AUC calculations for technique failure and mortality. Conclusions PAR was a risk factor associated with technique failure and mortality in PD patients.
To observe the effect of predictive nursing intervention in preventing complicated phlebitis in colon cancer patients receiving peripherally inserted central catheter. A total of 115 colon cancer patients who underwent peripherally inserted central catheter in our hospital from June 2018 to June 2020 were selected as the study subjects and divided into 2 groups according to the order of admission. 57 cases in the control group received routine nursing intervention. 58 patients in the study group received predictive nursing intervention. The occurrence of phlebitis, the first occurrence time of phlebitis, the average catheterization duration and nursing satisfaction were compared between the two groups. The total incidence of phlebitis was 6.90 % in the study group, which was lower than 21.05 % of the control group, showing statistically significant difference between the groups (p<0.05). The study group had later first occurrence time of phlebitis (p<0.05) and longer average catheterization duration than the control group (p<0.05). The nursing satisfaction was 91.38 % in the study group, which was higher than 77.19 % of the control group, showing statistically significant difference between the groups (p<0.05). Predictive nursing intervention can effectively prevent complicated phlebitis in colon cancer patients receiving peripherally inserted central catheter, delay the occurrence of phlebitis, prolong the average catheterization duration and receive high patient satisfaction.
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